Tibiofemoral Osteoarthritis and Varus–Valgus Laxity

Contributing USMA Research Unit(s)

Civil and Mechanical Engineering

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Publication Title

Journal of Knee Surgery

Document Type



The purpose of this study was to systematically review and synthesize the literature measuring varus–valgus laxity in individuals with tibiofemoral osteoarthritis (OA). Specifically, we aimed to identify varus–valgus laxity differences between persons with OA and controls, by radiographic disease severity, by frontal plane knee alignment, and by sex. We also aimed to identify if there was a relationship between varus–valgus laxity and clinical performance and self-reported function. We systematically searched for peer-reviewed original research articles in PubMed, Scopus, and CINAHL to identify all existing literature regarding knee OA and objective measurement of varus–valgus laxity in vivo. Forty articles were identified that met the inclusion criteria and data were extracted. Varus–valgus laxity was significantly greater in individuals with OA compared with controls in a majority of studies, while no study found laxity to be significantly greater in controls. Varus–valgus laxity of the knee was reported in persons with OA and varying degrees of frontal plane alignment, disease severity, clinical performance, and self-reported function but no consensus finding could be identified. Females with knee OA appear to have more varus–valgus laxity than males. Meta-analysis was not possible due to the heterogeneity of the subject populations and differences in laxity measurement devices, applied loading, and laxity definitions. Increased varus–valgus laxity is a characteristic of knee joints with OA. Large variances exist in reported varus–valgus laxity and may be due to differences in measurement devices. Prospective studies on joint laxity are needed to identify if increased varus–valgus laxity is a causative factor in OA incidence and progression.

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